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The Development of Satisfaction Tool to Health Care Services - focused on Patients and their families - (의료 서비스에 대한 만족도 측정 도구의 개발)

  • Kang, So-Young;Lee, Sun-Mi
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.104-124
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    • 1996
  • Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

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The Usefulness of a Wearable Smart Insole for Gait and Balance Analyses After Surgery for Adult Degenerative Scoliosis: Immediate and Delayed Effects (척추측만증 환자의 수술 효과 평가 수단으로서 웨어러블 스마트 깔창을 이용한 보행분석의 유용성)

  • Seo, Min Seok;Shin, Myung Jun;Kwon, Ae Ran;Park, Tae Sung;Nam, Kyoung Hyup
    • Journal of Convergence for Information Technology
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    • v.10 no.2
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    • pp.184-192
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    • 2020
  • This study presents a gait analysis method (including time series analysis) using a smart insole as an objective and quantitative evaluating method after lumbar scoliosis surgery. The participant is a degenerative lumbar scoliosis patient. She took 3-min-gait-test four times(before and 8, 16, and 204-days after surgery) and 6-min-gait-test once(204-days after surgery) with smart-insoles in her shoes. Each insole has 8-pressure sensors, an accelerometer, and a gyroscope. The measured values were used to compare the characteristics of gait before and after surgery. The analysis showed that all of the patient's gait parameters improved after surgery. And after 6 months, the gait was more stable. However, after long walk, the swing duration of one leg was slightly shorter than that of the other again. It was a preclinical problem that could not be found in the visual examination by the practitioner. With this analysis method we could evaluate the improvement of patient quantitatively and objectively. And we could find a preclinical problem. This analysis method will lead to the studies that define and distinguish gait patterns of certain diseases, helping to determine appropriate treatments.

A Study on the Utilization of a Rural Health Subcenter for Primary Health Care (일개 농촌지역주민의 면보건지소 이용실태에 관한 고찰 -경기도 남양주군 수동면-)

  • Kim, Young-Bok;Wie, Cha-Hyung
    • Journal of agricultural medicine and community health
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    • v.19 no.1
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    • pp.31-39
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    • 1994
  • We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

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A Study of the Effects of Health Contracting on Compliance with Health Behaviors in Clients with Hypertension (자가간호증진을 위한 건강계약이 고혈압자의 건강행위 이행에 미치는 영향)

  • 이향련
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.204-217
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    • 1987
  • It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t=-5.29, df=62, p=.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t=2.72, df=62, p=.009, for diastolic blood pressure t=1.95, df=62, p=.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r=-.2981, p=.008, for diastolic pressure r=-.1720, p=.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

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A SURVEY OF DENTAL TREATMENT UNDER GENERAL ANESTHESIA (전신마취하에 치료한 환자에 대한 실태조사)

  • Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Kwon, Byoung-Woo;Yang, Yeon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.317-322
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    • 2006
  • Dental caries in children has declined over the past few decades. However, Certain populations of children experience high levels of dental disease. To perform the highest quality dental care for the pediatric patient, the practitioner may need to use pharmacological means to obtain a quiescent, cooperative patient. Furthermore, complex treatment can impose high demands on the very young, making use of general anesthesia the preferred approach for some patients. General anesthesia is widely used to provide comprehensive dental treatment for children in USA and Europe and Scandinavia etc. Parental and patient satisfaction following completion of dental care under general anesthesia is reportedly high. Dental general anesthesia has disadvantage that it is expansive and carries a small but significant risk of mortality. However, It has the advantage of permitting treatment at a single visit, allowing immediate relief of pain and requiring little or no cooperation from the child. Rampant caries was the major indication for use of general anesthesia in the youngest age group or medically compromised patients. This study describe the characteristics of patient receiving comprehensive dental treatment under general anesthesia at the pediatric dentistry of Chonbuk National University Hospital in Jeonju, Korea in the 4year period between December 2001 and April 2005.

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Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA) : Extending the CONSORT Statement (STRICTA(침 임상연구에서 중재 보고를 위한 표준) 개정판: CONSORT Statement의 확충안)

  • Lee, Hyang-Sook;Cha, Su-Jin;Park, Hi-Joon;Seo, Jung-Chul;Park, Jong-Bae J.;Lee, Hye-Jung
    • Korean Journal of Acupuncture
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    • v.27 no.3
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    • pp.1-23
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    • 2010
  • Objectives and methods : The Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) were published in five journals in 2001 and 2002. These guidelines, in the form of a checklist and explanations for use by authors and journal editors, were designed to improve reporting of acupuncture trials, particularly the interventions, thereby facilitating their interpretation and replication. Subsequent reviews of the application and impact of STRICTA have highlighted the value of STRICTA as well as scope for improvements and revision. To manage the revision process a collaboration between the STRICTA Group, the CONSORT Group, and the Chinese Cochrane Centre was developed in 2008. An expert panel with 47 participants was convened that provided electronic feedback on a revised draft of the checklist. At a subsequent face-to-face meeting in Freiburg, a group of 21 participants further revised the STRICTA checklist and planned dissemination. Results : The new STRICTA checklist, which is an official extension of CONSORT, includes six items and 17 sub-items. These set out reporting guidelines for the acupuncture rationale, the details of needling, the treatment regimen, other components of treatment, the practitioner background, and the control or comparator interventions. In addition, and as part of this revision process, the explanations for each item have been elaborated, and examples of good reporting for each item are provided. In addition, the word "controlled" in STRICTA is replaced by "clinical", to indicate that STRICTA is applicable to a broad range of clinical evaluation designs, including uncontrolled outcome studies and case reports. Conclusions : It is intended that the revised STRICTA, in conjunction with both the main CONSORT Statement and extension for nonpharmacologic treatment, will raise the quality of reporting of clinical trials of acupuncture.

The Prevalence, Health behaviors, and Control of Hypertension in Rural Areas in Korea (보건진료소 관할 농촌지역 주민의 고혈압 유병률, 건강행태 및 고혈압 관리 양상)

  • Chungbuk CHP research team, Chungbuk CHP research team;Jeon, Mi-Yang
    • Research in Community and Public Health Nursing
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    • v.14 no.3
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    • pp.507-519
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    • 2003
  • Purpose: The purpose of this study was to identify the prevalence, health behaviors, and control of hypertension in rural areas in Korea. Method: A total of 927 subjects above age 20 were selected from the areas which fell under the jurisdiction of the 24 Community Health Center located in Chungcheongbuk-do. The employees in the Community Health Center visited and interviewed patients. Data were collected using a questionnaire from July to October 2002. Result: The result showed that women had higher hypertension prevalence rates than men and the increment of its rate leveled up according to age. The hypertension prevalence rate was significantly high when the monthly income was less than 1 million won, their type of the Medical Insurance was the Guardian, they were only able to read Korean characters, and they were bereaved of spouses. In the Health behavior related to hypertension, the hypertension group showed a significantly lower level than the non- hypertension group in terms of drinking rate, smoking rate, intake of salt and intake of meat. There was no significant difference in the exercise rate and coffee intake rate between these groups. In the degree of the obesity the hypertension group was significantly higher than the non-hypertension group. The factors related to hypertension were that the duration for the incidence of hypertension was 12 to 60 months and took up 41.2%. The places where the medical check-ups occurred were the Community Health Center at 46.6%, the medical institution was mostly hospitals recording 46.5%. There were 66.1% of the targets who knew well about their blood pressure and there were 64.7% people who received education about it. As for the education place, the rate of Community Health Center was mostly high and it stood at 77.0%. In the aspect of the management of hypertension, the targets who took medicine on a regular basis were up to 76.1% and the targets who measured blood pressure once a month happened to be about 46.1 %. The targets who always recorded their blood pressure were 3.8%, chest X-ray as a related examination of hypertension reached 32.6%, electrocardiogram examination was 36.2%, cholesterol and serum lipid examination took up 33.6%, and the eye ground examination took 7.3%, which showed the lowest level of all.

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Nexus based Quality Inspection Support Model for Defect Prevention of Architectural Finishing Works (하자예방정보 넥서스 기반 건축마감공사 품질점검 지원 모델)

  • Lee, Hye-Rin;Cho, Dong-Hyun;Park, Sang-Hun;Koo, Kyo-Jin
    • Korean Journal of Construction Engineering and Management
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    • v.18 no.5
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    • pp.59-67
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    • 2017
  • At the completion of the construction, various finishing processes are concentrated. This imposes a burden on the on-site manager and imposes on experience based quality control, thereby causing deviations in the quality of construction depending on supervisor or worker's individual competence. In addition, the information related to quality control is frequently scattered in various types of documents such as specifications and drawings, and checkpoints are frequently omitted. It is necessary to provide a tool that can effectively provide the practitioner before or during the inspection work by systematically storing the information related to the defect prevention and linking them in a mutually referential state. This paper proposes an quality inspection support model that can systematically store necessary information on activity or room basis for the quality check of the apartment house finishing work. Establish a defect prevention information base and a information nexus by linking specifications, design standards, checklists, regulations, defect cases, and drawings to the finishing process and the rooms. Based on this, information registration and search interface are presented. It can contribute to securing a certain level of construction quality or more by suggesting a frame that can be utilized by linking various defects prevention information with the focus on closing activity and room.

A Study on the Preferences of Dental Technology Students for Overseas Employment (치기공과 학생들의 해외취업에 대한 선호도 조사)

  • Kim, Im-Sun;Kim, Jeong-Sook
    • Journal of Technologic Dentistry
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    • v.34 no.3
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    • pp.303-314
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    • 2012
  • Purpose: This study aimed to find overseas workplace and improve global competence through the preference survey on overseas employment by dental technology students. Methods: The survey sample consisted of 250 randomly selected dental technology students. Survey was conducted from March 1 to May 1 in 2012. Total of 245(98.0%) replies and analyzed 236 questionnaires excluding 9 incomplete questionnaires. The questionnaires used in this study consisted of 7 items for general information, overseas employment characteristics of 10 items, 7 items for overseas employment activation plane and job competency development of 7 items. Collected data were analyzed using SPSS(Statistical Package for Social Sciences) Win 19.0 statistics program. Results: Regarding general characteristics of the subjects, there were 131 third graders(55.5%), 63 first graders(26.7%) and 42 second graders(17.8%) among 130 males(55.1%) and 106 females(44.9%). 221(93.6%) of the subjects had no experience in language training. Students who had clinical training for 1-5 months were 123(52.1%), and 24(10.2%) students had more than six months. 89(37.7%) of the subjects had no clinical training. 155(65.7%) of the subjects hope to work with korean owner, and 81(34.3%) chose foreign owner. Favored working countries were Australia(41.5%), the United States(29.2%), Canada(18.2%) and other(11.0%). The field of dental ceramic was indicated to be the highest proportion of 104(44.1%). Period of training were 3 hours(40.3%) and 6 hours(35.2%). The most important training were language-centered education(54.2%), Job-oriented education(24.2%), local culture education(16.1%), other(3.0%) and Leadership Training(2.5%). The subjects chose overseas worker(44.9%), working-level practitioner (28.8%), successfully employed dental technology graduate(19.5%a) and professor(3.4%) as an instructor. The subjects get education and training information from professor(40.3%), other(28.0%), senior(14.4%), job site(8.9%) and acquaintance(8.5%). A credit exchange(2.46 points), a joint degree program(2.46 points), and a foreign professor(2.33 points) were needed to activate the overseas employment. A kind of dental prosthesis(3.58 points), carving tooth morphology(3.38 points), and majors of dental technology(3.30 points) were indicated to develop job competency for overseas employment. Age, year, clinical training experience and company owner were statistically meaningful data among the general characteristics affecting job competency development. Conclusion: The college needs to offer variety programs such as foreign language-centered education and a local job competency development program to graduates to be connected with international workplace and employment.

A study on zhenjiusunanyaozhi(鍼灸素難要旨) (침구소난요지(鍼灸素難要旨)에 대한 연구(硏究))

  • Sim, Cheol-Ung;Kim, Jae-Jung;Kim, Jang-Saeng;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.17 no.2
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    • pp.130-287
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    • 2011
  • "zhenjiusunanyaozhi(鍼灸素難要旨)" is composed of three volumes and published in 1529 by Gao Wu(高武). Gao Wu(高武) is skillful in astronomy, the art of war and the law as well as a medical practitioner in Ming Dynasty. The books he wrote "zhenjiujuying(鍼灸聚英)", "zhizhi(直指)", "douzhenzhengzong(痘疹正宗)", "shexuezhinan(射學指南)", "zhenjiujieyao(鍼灸節要)". "zhenjiusunanyaozhi鍼灸素難要旨" is written by classifying the origin of acupuncture and moxibustion. In other words, it is edited by classifying the contents related to acupuncture and moxibustion out of the ancient Chinese medical book "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" in which are composed of 3 volumes as follows, Volume 1 says the main diseases on "the nine acupuncture needles figure" (九針圖), "the reinforcing and reducing the meridian" (補瀉), "the needle depth" (針刺深淺), "the five shu points - metal, wood, water, fire, earth" (正,滎,輸,經,合) based on 18 chapters in terms of acupuncture in "yellow emperor eighty-one Difficult "難經"", in which it quotes the annotation of "the difficulty by the original meaning "難經本義"" written by Hua Shou(滑壽) in Yuan Dynasty. Volume 2 is composed of 2 parts. Part 1 says the method of treatment on 36 Chapters, the method of acupuncture use in the Linshu "靈樞" and the Suwen "素問" such as "the rule of acupuncture use" (用針方宜), "the nine-pin method" (九針式) and "the nine-pin to only use the time appropriate to consider nature of Heaven, Earth and person" (九針應天地人時以起用) etc., Part 2 says "the five difficult acupuncture(五亂刺)", "the rise and fall of energy and blood(氣血盛衰)". "the pain tolerance(耐痛)" and ect., in which are in terms of method of treatment collected the original texts of 59 chapters on acupuncture to each disease and of 8 chapters on moxibustion in the Linshu "靈樞" and the Suwen "素問". Volume 3 includes 10 chapters in which consist of "the stabbing to disease in 12 meridians (十二經病刺)", "the eight extra meridian disease (寄經八脈病)", "the twelve meridians(十二經脈)", "the fifteen collaterals (十五絡脈), the twelve meridian muscles (十二經筋)", "the acupoint (孔穴)" and etc. This is the book edited comprehensively by classifying the contents on the theory of acupuncture and moxibustion and the circulations of meridians in "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" and there is no case story in particular except his comments in person. This study is for the purpose of helping researching and developing acupuncture and moxibustion and applying their clinical training.

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